Intensive, Multi-Couple Group Therapy for PTSD: A Nonrandomized Pilot Study With Military and Veteran Dyads

Fredman, Steffany J.; Macdonald, Alexandra; Monson, Candice M.; Dondanville, Katherine A.; Blount, Tabatha H.; Hall-Clark, Brittany N.; Fina, Brooke A; Mintz, Jim; Litz, Brett T.; Young‐McCaughan, Stacey; Hancock, Allison K; Rhoades, Galena K.; Yarvis, Jeffrey S.; Resick, Patricia A.; Roache, John D.; Le, Yunying; Wachen, Jennifer Schuster; Niles, Barbara L.; McGeary, Cindy A.; Keane, Terence M.; Peterson, Alan L.

doi:10.1016/j.beth.2019.10.003

Cited by 32 publications

(47 citation statements)

References 33 publications

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“…Couple HOPES consists of seven interactive modules (see Table 2 for a brief overview of Couple HOPES content by module). Unlike CBCT for PTSD, Couple HOPES does not formally target PTSD-related beliefs in light of data suggesting that PTSD improves in CBCT for PTSD prior to the introduction of this content ( Fredman et al, 2019 ; Monson et al, 2012 ) (see Monson et al, in press , for full intervention description including changes from CBCT for PTSD). Before each module, both partners complete self- or collateral-report measures of PTSD symptoms (PCL-5) and relationship satisfaction (CSI-4).…”

Section: Methodsmentioning

confidence: 99%

Initial outcomes of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement

Fitzpatrick

Wagner

Crenshaw

et al. 2021

Internet Interventions

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Couple HOPES (Helping Overcome PTSD and Enhance Satisfaction) is a guided, online couple intervention adapted from Cognitive-Behavioral Conjoint Therapy for posttraumatic stress disorder (PTSD). It was created to overcome a range of barriers to accessing evidence-based treatments for PTSD and the intimate relationship problems associated with it. This manuscript describes initial outcomes of the intervention in a series of 10 couples. Participants were military, veteran and first responders with probable PTSD and their intimate partners. Couples completed the program and measurements of PTSD, relationship satisfaction, and secondary outcomes at pre-, mid-, and post-intervention. Mean satisfaction for the program was high and it was completed by seven of ten couples. Participants with PTSD evidenced significant and large pre- to post-intervention effect size improvements in PTSD symptoms ( g = 0.80) and perceived health ( g = 1.13). They also exhibited non-significant but medium effect size pre- to post-intervention improvements in quality of life ( g = 0.62), and depression ( g = 0.53), and small effect size pre- to post-intervention improvements in argumentativeness ( g = 0.43), anger ( g = 0.31), and anxiety ( g = 0.31). Partners reported significant and moderate pre- to post-intervention effect size improvements in relationship satisfaction (g = 0.68 ), and medium but not significant effect size improvements in accommodation of PTSD ( g = 0.56). Results provide initial support for the feasibility, acceptability, and efficacy of Couple HOPES for improving PTSD and relationship satisfaction. However, more testing in larger samples, including with randomized controlled designs, is needed.

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Section: Methodsmentioning

confidence: 99%

Initial outcomes of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement

Fitzpatrick

Wagner

Crenshaw

et al. 2021

Internet Interventions

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“…There are also a number of family-inclusive treatments for PTSD (Johnson, 2002;Monson et al, 2012;Sautter et al, 2015), but all of the existing protocols require multiple conjoint sessions over several months, posing a significant barrier to treatment access. The most well-known and commonly used family-inclusive treatment is cognitive behavioral conjoint therapy for PTSD (CBCT; Monson et al, 2012), a 15-session, fully dyadic intervention based on the cognitive behavioral interpersonal theory of PTSD (Monson et al, 2010); an 8-session CBCT protocol (Morland et al, 2019) and an intensive multicouple CBCT protocol (Fredman et al, 2020) have also been tested. The CBCT intervention includes many treatment elements, including addressing maladaptive traumaand relationship-related thoughts and encouraging couples to undertake in vivo exposure exercises.…”

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confidence: 99%

The Use of a Brief Family Intervention to Reduce Dropout Among Veterans in Individual Trauma‐Focused Treatment: A Randomized Controlled Trial

Thompson‐Hollands

Lee

Sloan

2021

Journal of Traumatic Stress

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Dropout from trauma‐focused treatment for posttraumatic stress disorder (PTSD) represents a daunting challenge for the field, particularly among military and veteran samples. Family involvement may help to increase the effectiveness of PTSD treatment while also improving retention. We tested a two‐session brief family intervention (BFI) protocol delivered as an adjunct to individual trauma‐focused treatment among a sample of 20 veteran–family member dyads (N = 40). Willingness to participate in the family‐inclusive protocol was high, with over 85% of veterans and family members who were screened agreeing to take part. All enrolled veterans were beginning a course of either cognitive processing therapy (CPT) or prolonged exposure (PE), delivered in outpatient Veterans Affairs clinics. Family members were randomized to either receive or not receive the BFI from study clinicians. In the BFI condition, 20.0% of veterans dropped out of CPT/PE before the 16‐week study end; the remainder were either still attending on‐protocol sessions or had completed the full protocol. In the control condition, 40.0% of veterans dropped out of CPT/PE before the end of the study. Observed significant, large‐magnitude decreases in PTSD symptoms over time did not differ by condition, ESsg range = −1.12 to −2.04. Accommodation did not significantly decrease over time in either condition, ESsg range = 0.18 to −0.98. The BFI represents a promising option for veterans, family members, and clinicians who are seeking a brief, feasible, narrowly focused method for incorporating families into veterans’ individual trauma‐focused therapy and potentially reducing the rate of dropout.

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“…Several studies presented above successfully adapted PE for military populations in various ways to improve access, reduce dropout, and enhance outcomes. These include shortening the time between sessions [39,40], reducing the number of sessions [42][43][44], providing web-based treatment [46], reducing the length of sessions [47], and conducting intensive weekend retreats for couples [61]. Similarly, a variable length CPT protocol successfully treated active duty military with improved outcomes [51] and demonstrated efficacy in multiple in-person or telehealth settings [54].…”

Section: Discussionmentioning

confidence: 99%

“…One of the primary challenges in conducting CBCT with military couples was that the military work environment made it very difficult for both spouses to attend the proposed 15 treatment sessions, resulting in a high dropout rate. To address these challenges, the treatment protocol was redesigned as an abbreviated, intensive, multi-couple group version of CBCT in which the entire treatment protocol was delivered as a 2-day weekend retreat [61]. The results of a nonrandomized clinical trial (N = 24 couples) that included an active duty service member or veteran who had previously deployed found significant reductions in both clinician-rated and self-reported PTSD symptoms as well as significant improvements in relationship satisfaction.…”

Section: Cognitive-behavioral Conjoint Therapymentioning

confidence: 99%

Assessment and Treatment of Combat-Related Posttraumatic Stress Disorder: Results from STRONG STAR and the Consortium to Alleviate PTSD

Peterson¹,

Niles²,

Young‐McCaughan³

et al. 2021

Current Topics on Military Medicine

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Extensive research has been conducted since 11 September 2001 to develop and evaluate evidence-based treatments for combat-related posttraumatic stress disorder (PTSD) in active duty United States military personnel treated in the combat theater and in garrison. This chapter reviews the results of 20 PTSD clinical trials funded by the United States Department of Defense and Department of Veterans Affairs on the treatment of combat-related PTSD. All of the studies were conducted under the leadership and management of two research consortia: the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience (STRONG STAR) Consortium and the Consortium to Alleviate PTSD.

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Intensive, Multi-Couple Group Therapy for PTSD: A Nonrandomized Pilot Study With Military and Veteran Dyads

Cited by 32 publications

References 33 publications

Initial outcomes of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement

Initial outcomes of couple HOPES: A guided online couple intervention for PTSD and relationship enhancement

The Use of a Brief Family Intervention to Reduce Dropout Among Veterans in Individual Trauma‐Focused Treatment: A Randomized Controlled Trial

Assessment and Treatment of Combat-Related Posttraumatic Stress Disorder: Results from STRONG STAR and the Consortium to Alleviate PTSD

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